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Don't buy into kidneys for sale argument
For some days last week I kept thinking that $20,000 seemed a pittance to pay a person to part with a kidney to save a stranger's life.
I had simply failed to do the maths the way Indonesian Sulaiman Damanik did, the day someone turned up at his home in rural Galang, near Medan in Sumatra, with an offer he found impossible to resist. If he would go to Singapore, lie that he was related to a sick man, and give up a kidney, he would be paid 150 million rupiah (about S$22,000). Here was a low-educated labourer who earned the equivalent of $120 a month until he lost his job in January. An only child, he lived with his parents and was the family's sole breadwinner. The sum offered added up to 16-1/2 years of his labourer's wages, a windfall nothing less than a godsend after months of his being jobless. Sulaiman said yes. But the scam was found out, the surgery was blocked and he ended up arrested and jailed here. All he got was $50. He was one of two Indonesians in the news this past fortnight in the kidneys-for-sale case. The other, Toni, had a similar story. Low-educated, former garbage collector, out of work. Someone turned up offering him a pile of cash, and he went through the full process, gave up a kidney and got paid. Then he joined the syndicate that recruited him. For more money, he became one of its runners and helped bring Sulaiman to Singapore. He too is in jail now. This simply has to be one of the saddest stories to emerge from Singapore's courts, and I wish it could have turned out differently for the sick person so anxious for a new lease of life, and the poor foreigner dazzled by the promise of big money. But I hope that as this story unravels - and it should, because the case also revealed an intricate kidneys-for-sale racket at work - it will not persuade everyone that the solution lies in making it legal to exchange human organs for cash. This case was sad because it revealed the utter desperation at both ends of the spectrum. For the sick person, good health is merely one transplant operation away. Singapore has a long line of kidney patients, for whom a transplant would mean a new life transformed immensely for the better. But, like everywhere else, there are simply not enough organs donated to meet demand. So most patients must wait and hope, suffering ill health, or they die if that much-needed donation does not arrive in time. None of us will know the agony of waiting in that queue until we are afflicted ourselves, or someone dear to us is. But it remains hard to leap from sympathy to saying, go ahead, allow this sale. The reason is, this case also demonstrated vividly what happens when those who can pay seek sellers. There are syndicates at work, with middlemen and runners, who scour villages in other countries to seek out the down-and-out individual who will part with a kidney for cash. Success is finding those in dire enough straits, such as Sulaiman or Toni. They can be coached to lie, sign a sworn statement claiming to be relatives of people they have never met, and keep up the pretence before experts at a hospital ethics committee. In the wake of publicity over this first-ever case of its kind, there have been calls to dump the law that forbids the sale of human organs. And it has been said that if any country can put in the safeguards necessary to do this properly, it is Singapore. What does that mean, really? What will change when it becomes legal to sell a part of your body and how will Singapore get it right? Will we set the world's best price for a human organ? Will we provide sturdy compensation for donors should surgery go wrong or complications leave them invalid? Instead of today's illegal syndicates, will we raise a breed of organ-matching agents who will source the region for donors and reap their cut of the money changing hands? And after we've okayed selling kidneys and livers, do we stop there, or move on to sticking price tags on blood, sperm, eggs, skin and bone marrow? After all, as with kidneys, we have more than we need. The mind boggles. It might well turn out worse than the exploitation we know that goes on in the recruitment of foreign workers, and the shameless way agents advertise maids like goods to be bought, sold and exchanged when found faulty. The issue of organ trading was debated in Parliament in 2004, and while lawmakers agreed to widen the scope of the Human Organ Transplant Act, they stood firm in rejecting the idea of organ trading. Although seemingly thorough safeguards were put in place to ensure that all live donations are above board, we now know that sworn documents can be packed with lies, and hospital ethics committees can be fooled. We should take care before rushing to change the law, and resist the smugness that tells us Singapore has what it takes to establish best practices in organ trading. Should the change happen, only those who can afford to pay will step out of the queue sooner to get their transplant. What will not change either, is that only the most financially strapped will resort to selling their organs. Recipients in Singapore will buy from the poorest folk in neighbouring countries, where $20,000 - or whatever the going rate becomes - will be the equivalent of several years' pay. As an organ-trading hub, we can expect to see a stream of poor Indonesians, Indians, Chinese, Filipinos, Myanmar people and Cambodians arriving to part with a kidney or a portion of their liver. Will we then just shrug it off and tell each other, it's tough, but that's life? Because, after all, the poorest people everywhere have always been prepared to leave their homelands to be maids, cleaners, labourers or sex workers for better money in wealthier countries? Everything we've learnt last week about Sulaiman and Toni ought to leave us outraged, and make us pause before saying yes to organ trading. There simply isn't a price high enough to make it all right. Send your comments to suntimes@sph.com.sg Instead of today's illegal syndicates, will we raise a breed of organ-matching agents who will source the region for donors and reap their cut of the money changing hands? And after we've okayed selling kidneys and livers, do we stop there, or move on to sticking price tags on blood, sperm, eggs, skin and bone marrow? After all, as with kidneys, we have more than we need.
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